We wish to acknowledge the support of the Find&Treat service – University College London Hospitals, without which the work could not have happened.
We wish to acknowledge the many specialist tuberculosis nurses, clinical teams and diagnostic services across London, Leicester, Coventry and Birmingham who contributed to the VOT trial (participating sites: Royal Free Hospital; Edgware Community Hospital; Whipps Cross University Hospital; Mile End Hospital; Newham University Hospital; Chelsea and Westminster Hospital; Whittington Hospital, Birmingham – Heart of England NHS Foundation Trust; Hammersmith Hospital; St Mary’s Hospital; Charing Cross Hospital, Leicester; Glenfield Hospital, Coventry; George Eliot Hospital; North Middlesex University Hospital, Birmingham; Sandwell General Hospital; Birmingham City Hospital; Croydon University Hospital; Northwick Park Hospital; Central Middlesex Hospital; Guy’s Hospital and St Thomas’ Hospital).
We wish to acknowledge the VOT trial independent steering group: Andrew Nunn (chairperson), Mark Woodhead (clinical representative), Anne Chapman (clinical representative), Claire Stephenson (tuberculosis nurse advisor) and Josie Mavromatis (Pathway representative).
We also wish to acknowledge the many services across London that supported the study, including the Groundswell peer advocacy charity, Pathway (London, UK), homeless hostels across London and London prisons.
Finally, we wish to acknowledge the patients who participated in the studies despite having often complex lives.
Contributions of authors
Alistair Story (https://orcid.org/0000-0003-3853-1715) (Honorary Senior Lecturer and Find&Treat Clinical Lead) contributed to the co-design of the programme grant, was co-lead for study implementation, and contributed to analysis and interpretation.
Elizabeth Garber (https://orcid.org/0000-0002-5962-3232) (Project Manager) contributed to the analysis, interpretation and drafting of reports.
Robert W Aldridge (https://orcid.org/0000-0003-0542-0816) (Research Fellow) contributed to the study implementation, was the lead for analysis, and contributed to analysis and interpretation.
Catherine M Smith (https://orcid.org/0000-0003-3959-8479) (Research Associate) contributed to the analysis of trial-based data and the compilation of the final report.
Joe Hall (https://orcid.org/0000-0002-7681-6124) (Research Associate) contributed to data collection and study implementation, and to the analysis and interpretation.
Gloria Ferenando (https://orcid.org/0000-0001-8580-3037) (Research Nurse) contributed to data collection and the VOT trial implementation, and to the analysis and interpretation.
Lucia Possas (https://orcid.org/0000-0001-9758-3449) (Study Data Manager) contributed to the study implementation, analysis and interpretation.
Sara Hemming (https://orcid.org/0000-0003-3487-0517) (Research Nurse) contributed to the study implementation, analysis and interpretation.
Fatima Wurie (https://orcid.org/0000-0003-4802-2308) (Research Assistant) contributed to the study implementation, analysis and interpretation.
Serena Luchenski (https://orcid.org/0000-0002-6260-4606) (Research Fellow) contributed to the study analysis and interpretation.
Ibrahim Abubakar (https://orcid.org/0000-0002-0370-1430) (Professor of Infectious Disease Epidemiology) contributed to the study design, implementation, analysis and interpretation.
Timothy D McHugh (https://orcid.org/0000-0003-4658-8594) (Professor of Microbiology) contributed to the study design, implementation, analysis and interpretation.
Peter J White (https://orcid.org/0000-0002-6644-3512) (Reader) contributed to the transmission modelling and economics.
John M Watson (https://orcid.org/0000-0002-2595-405X) (Honorary Professor of Epidemiology) contributed to the study design, implementation, analysis and interpretation.
Marc Lipman (https://orcid.org/0000-0001-7501-4448) (Consultant in Respiratory Medicine) contributed to the study design, implementation, analysis and interpretation, and was the clinical lead.
Richard Garfein (https://orcid.org/0000-0003-3663-7153) (Professor of Global Health) contributed to the VOT study design, implementation, analysis and interpretation.
Andrew C Hayward (https://orcid.org/0000-0002-3549-6232) (Professor of Infectious Disease Epidemiology and Inclusion Health) was the chief investigator, contributed to the co-design of the programme grant and was co-lead for study implementation, contributed to analysis and interpretation, and collation of the final report.
Publications
The following publications have arisen directly or indirectly (e.g. as a result of methodological developments and collaborations that would not have otherwise happened) from this programme grant.
Work arising directly from work packages 1 and 2 (screening for latent tuberculosis and blood-borne viruses)
Aldridge RW, Yates S, Hemming S, Possas L, Garber E, Lipman EM, et al. Latent TB infection and bloodborne viruses in a London prison: a cross sectional survey. Int J Epidemiol 2015;44:i247.
Aisyah DN, Shallcross L, Hayward A, Aldridge RW, Hemming S, Yates S, et al. Hepatitis C virus infection in vulnerable populations: a seroprevalence study of homeless, people who inject drugs and prisoners in London, UK. Lancet 2017;390:S18.
Aisyah DN, Shallcross L, Hayward A, Aldridge RW, Hemming S, Yates S, et al. Hepatitis C among vulnerable populations: a seroprevalence study of homeless, people who inject drugs and prisoners in London. J Viral Hepat 2018;25:1260–9.
Aldridge RW, Hayward AC, Hemming S, Yates SK, Ferenando G, Possas L, et al. High prevalence of latent tuberculosis and bloodborne virus infection in a homeless population. Thorax 2018;73:557–64.
Work arising from the health survey conducted alongside work package 1
Story A, Aldridge RW, Gray T, Burridge S, Hayward AC. Influenza vaccination, inverse care and homelessness: cross-sectional survey of eligibility and uptake during the 2011/12 season in London. BMC Public Health 2014;14:44.
Aldridge RW, Hayward A, Story A. Homelessness and quality adjusted life years: slopes and cliffs in health inequalities a cross-sectional survey. Int J Epidemiol 2015;44:80–81.
Work arising directly from work package 3 (effectiveness of peer educators)
Aldridge RW, Hayward AC, Hemming S, Possas L, Ferenando G, Garber E, et al. Effectiveness of peer educators on the uptake of mobile X-ray tuberculosis screening at homeless hostels: a cluster randomised controlled trial. BMJ Open 2015;5:e008050.
Work conducted alongside work package 3
Croft LA, Hayward AC, Story A. Tuberculosis peer educators: personal experiences of working with socially excluded communities in London. Int J Tuberc Lung Dis 2013;17(Suppl. 10):36–40.
Work arising directly from work package 4 (rapid diagnosis)
Gliddon HD, Shorten RJ, Hayward AC, Story A. A sputum sample processing method for community and mobile tuberculosis diagnosis using the Xpert MTB/RIF assay. ERJ Open Res 2019;5:00165–2018.
Work arising directly from work package 5 (randomised controlled trial of video-observed therapy)
Story A, Aldridge RW, Smith CM, Garber E, Hall J, Ferenando G, et al. Smartphone-enabled video-observed versus directly observed treatment for tuberculosis: a multicentre, analyst-blinded, randomised, controlled superiority trial. Lancet 2019;393:1216–24.
Work arising indirectly from work package 5
Falzon D, Timimi H, Kurosinski P, Migliori GB, Van Gemert W, Denkinger C, et al. Digital health for the End TB Strategy: developing priority products and making them work. Eur Respir J 2016;48:29–45.
Story A, Garfein RS, Hayward A, Rusovich V, Dadu A, Soltan V, et al. Monitoring therapy compliance of tuberculosis patients by using video-enabled electronic devices. Emerging Infect Dis 2016;22:538–40.
Studies using the linkage algorithm developed for the programme grant
Aldridge RW, Shaji K, Hayward AC, Abubakar I. Accuracy of probabilistic linkage using the enhanced matching system for public health and epidemiological studies. PLOS ONE 2015;10:e0136179.
Aldridge RW, Zenner D, White PJ, Williamson EJ, Muzyamba MC, Dhavan P, et al. Tuberculosis in migrants moving from high-incidence to low-incidence countries: a population-based cohort study of 519,955 migrants screened before entry to England, Wales and Northern Ireland. Lancet 2016;388:2510–18.
Publications on tuberculosis and social exclusion arising from collaborations fostered by the programme grant
van Hest NA, Aldridge RW, de Vries G, Sandgren A, Hauer B, Hayward A, et al. Tuberculosis control in big cities and urban risk groups in the European Union: a consensus statement. Euro Surveill 2014;19:20728.
Anderson C, Anderson SR, Maguire H, Hayward AC, Story A. Tuberculosis in London: the convergence of clinical and social complexity. Eur Respir J 2016;48:1233–6.
Publications on health and social exclusion arising from collaborations fostered by the programme grant
Aldridge RW, Story A, Hwang SW, Nordentoft M, Luchenski SA, Hartwell G, et al. Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis. Lancet 2017;391:241–50.
Blackburn RM, Hayward A, Cornes M, McKee M, Lewer D, Whiteford M, et al. Outcomes of specialist discharge coordination and intermediate care schemes for patients who are homeless: analysis protocol for a population-based historical cohort. BMJ Open 2017;7:e019282.
Luchenski S, Maguire N, Aldridge RW, Hayward A, Story A, Perri P, et al. What works in inclusion health: overview of effective interventions for marginalised and excluded populations. Lancet 2018;391:266–80.
Data-sharing statement
All data requests should be submitted to the corresponding author for consideration. Access to anonymised data may be granted following review.
Patient data
This work uses data provided by patients and collected by the NHS as part of their care and support. Using patient data is vital to improve health and care for everyone. There is huge potential to make better use of information from people’s patient records, to understand more about disease, develop new treatments, monitor safety, and plan NHS services. Patient data should be kept safe and secure, to protect everyone’s privacy, and it’s important that there are safeguards to make sure that it is stored and used responsibly. Everyone should be able to find out about how patient data are used. #datasaveslives You can find out more about the background to this citation here: https://understandingpatientdata.org.uk/data-citation.
Disclaimers
This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, CCF, NETSCC, PGfAR or the Department of Health and Social Care. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the PGfAR programme or the Department of Health and Social Care.